四失之义，大略已见五过中，此不过敷衍成文，以尽一篇之名目而已。
黄帝在明堂，雷公侍坐。黄帝曰∶……子所通书受事众多矣，试言得失之意。……雷公对曰∶循经受业，
皆言十全，其时有过失者，请闻其事解也。（按∶言居恒自以为是，而及其施用，则不能无失，故公更问其解
也。）帝曰∶子年少，智未及邪？将言以杂合耶？（按∶言以杂合，谓惑于众说而不能择也。）夫经脉十二，
络脉三百六十五，此皆人之所明知，工之所循用也。所以不能十全者，精神不专，志意不理，外内相失，故时
疑殆。（外谓色，内谓脉也。然精神不专于循用，志意不从于条理，所谓粗略，揆度失常，故色脉相失，而时
自疑殆也。）诊不知阴阳逆从之理，此治之一失也。（脉要精微论曰∶“冬至四十五日，阳气微上，阴气微下；
夏至四十五日，阴气微上，阳气微下。阴阳有时，与脉为期。”又曰∶“微妙在脉，不可不察，察之有纪，
从阴阳始。”由此故诊不知阴阳逆从之理，为一失矣。）受师不卒，妄作杂术，谬言为道，更名自功，妄用砭
石，后遗身咎，此治之二失也。（不终师术，惟妄是为，易古变常，自功循己，遗身之咎，不亦宜乎，故为失
二也。）不适贫富贵贱之居，坐之薄浓，形之寒温，不适饮食之宜，不别人之勇怯，不知比类，足以自乱，不
足以自明，此治之三失也。（贫贱者劳，富贵者佚；佚则邪不能伤，劳则易伤以邪。其于劳也，则富者处贵
者之半；其于邪也，则贫者居贱者之半。例率如此，然世禄之家，或
此殊矣。夫勇者难惑，怯者易伤，二者不同，盖以其神气有壮弱也。观其贫贱富贵之义，则坐之薄浓，形之寒
温，饮食之宜，理可知矣。不知比类，用必乖误，适足以汨乱心绪，岂通明之可望乎，故为失三也。）诊病不
问其始，忧患饮食之失节，起居之过度，或伤于毒，不先言此，卒持寸口，何病能中，妄言作名，为粗所穷，
此治之四失也……。（忧谓忧惧也。患谓患难也。饮食失节，言甚饱也。起居过度，言溃耗也。或伤于毒，谓
病不可拘于脏腑相乘之法而为疗也。按∶不识致病之因，而但持寸口，名为诊脉，而实不知病之名，此四失也，
比比然矣。）是故治不能循理，弃术于市，妄治时愈，愚心自得。（按∶不学无术，徒 卖于市KT 之间，
偶或一中，便尔矜夸，以此终身，过不胜数。）呜呼！窈窈冥冥，孰知其道。（……按∶至道高玄，举世蒙昧，
是可叹也。）
“四失”的含义，大致已经在《五过》篇中提及了，这里不过是铺陈文字以完成本篇的标题内容罢了。
黄帝在明堂，雷公侍坐在一旁。黄帝说：“……你所通晓的书籍和接受的医术很多，试着谈谈你对得失的看法。”……雷公回答说：“我遵循经脉理论从师学习，都说能取得十全的效果，但有时出现过失，请问其中的原因是什么？（按：意思是平时自以为是，等到实际施治时，却不能没有失误，所以雷公进一步询问其解释。）”黄帝说：“是你年纪轻，智慧还没达到吗？还是因为你的学说杂乱无章？”（按：所谓“杂合”，是指被各种说法迷惑而不能选择正确的。）十二经脉、三百六十五络脉，这些都是人们所熟知的，也是医生所遵循使用的。之所以不能做到十全十美，是因为精神不专注，意志不条理，内外（色与脉）不相协调，所以时常产生疑惑和危险。（外指面色，内指脉象。然而精神不专注于遵循使用，意志不顺应条理，这就是所谓的粗略，揣度失常，导致色脉不相符合，因而时常自我怀疑和担忧。）诊断时不了解阴阳逆顺的道理，这是治疗上的第一种失误。（《脉要精微论》说：“冬至后四十五日，阳气微微上升，阴气微微下降；夏至后四十五日，阴气微微上升，阳气微微下降。阴阳变化有定时，与脉象相应。”又说：“脉象的精妙微妙之处，不可不仔细考察，考察它有纲纪，从阴阳开始。”因此，诊断时不了解阴阳逆顺的道理，成为第一种失误。）跟随老师学习未能结业，就胡乱编造杂术，谬误地称之为大道，改名换姓以标榜自己的功劳，妄用砭石，给自身留下祸患，这是治疗上的第二种失误。（不能坚持老师的医术，只凭妄为行事，改变古法常规，自我夸耀，给自己留下祸患，不也是应该的吗？所以列为第二种失误。）不根据患者贫富贵贱的生活环境，衣着厚薄，体形寒温的不同，也不根据饮食适宜与否，不区分人的勇敢与怯弱，不知道运用类比推理，足以使自己混乱，不足以使自己明白，这是治疗上的第三种失误。（贫贱者多劳碌，富贵者多安逸；安逸则邪气难以伤害身体，劳碌则容易受邪气伤害。对于劳碌而言，富人处于贵者的一半程度；对于邪气而言，穷人处于贱者的一半程度。大抵如此，然而世袭禄位之家，或许与此不同。勇敢的人难以被迷惑，怯弱的人容易受伤，两者不同，大概是因为神气的强弱不同。观察贫贱富贵的道理，那么衣着的厚薄、体形的寒温、饮食的适宜，道理也就可知了。不知道运用类比，用药必然乖谬错误，只能扰乱心绪，哪里还能指望通明呢？所以列为第三种失误。）诊断疾病不问及其起始情况，忧患情绪、饮食失节、起居过度，或者是否中毒，如果不先说明这些，突然把持寸口脉诊，怎么能准确判断疾病？胡乱命名，被粗疏所困穷，这是治疗上的第四种失误……。（忧指忧惧，患指患难。饮食失节，指吃得太饱。起居过度，指耗损过度。或伤于毒，指病情不能拘泥于脏腑相乘的方法进行治疗。按：不认识致病的原因，而只是把持寸口脉诊，名义上是诊脉，实际上并不知道疾病的名称，这种四失的情况，比比皆是。）因此，治疗不能遵循理法，将医术抛弃在市井之间，胡乱治疗却偶尔痊愈，愚昧之心自我满足。（按：不学无术，只在市井间卖弄，偶尔中了一次，便自我矜夸，以此度过终身，过错数不胜数。）唉！道深远幽暗，谁能知晓它呢？（……按：至高之道高深玄妙，举世之人蒙昧无知，真是可叹啊。）
The meaning of the "Four Errors" has largely been seen in the "Five Excesses" (Wu Guo) chapter; this section merely elaborates to fulfill the title of the chapter.
Yellow Emperor was in the Ming Tang, with Lei Gong attending as a seated guest. Yellow Emperor said: "...You have mastered many books and received extensive teachings. Try to express your views on gains and losses." ... Lei Gong replied: "Following the meridians for my studies, it is said that one can achieve perfect success (Shi Quan). However, errors sometimes occur. I ask for an explanation of these matters." (Note: This implies that while one may be self-assured in daily practice, errors inevitably arise during actual treatment, hence Lei Gong seeks clarification.) Yellow Emperor said: "Is it because you are young and your wisdom has not yet matured? Or is your knowledge a confused amalgamation?" (Note: "Amalgamation" refers to being confused by various theories and failing to select the correct ones.) The twelve primary meridians (Jing Mai) and three hundred sixty-five collaterals (Luo Mai) are well-known to people and are followed by physicians. The reason why perfection cannot always be achieved is that the spirit (Shen) is not focused, the will (Zhi) is not orderly, and the internal and external aspects are out of harmony, leading to frequent doubt and danger. (External refers to complexion, internal refers to pulse. If the spirit is not focused on proper application and the will does not follow logical order, resulting in rough estimation and失常 (abnormal judgment), the complexion and pulse will mismatch, causing self-doubt and anxiety.) Failing to understand the principles of Yin-Yang and their reversal or adherence (Ni Cong) during diagnosis constitutes the first error in treatment. (The *Ling Shu: Mai Yao Jing Wei Lun* states: "Forty-five days after Winter Solstice, Yang Qi rises slightly and Yin Qi descends slightly; forty-five days after Summer Solstice, Yin Qi rises slightly and Yang Qi descends slightly. Yin and Yang have their times, corresponding to the pulse." It also states: "The subtlety lies in the pulse, which must not be neglected. Its examination has a principle, starting from Yin and Yang." Thus, failing to understand the principles of Yin-Yang and their reversal or adherence becomes the first error.) Not completing one's apprenticeship under a master, but instead fabricating miscellaneous techniques, falsely claiming them as the Great Dao, changing names to claim credit, and recklessly using Bian stones (Bian Shi), thereby bringing blame upon oneself, constitutes the second error in treatment. (Failing to finish learning the master's art and acting arbitrarily, altering ancient methods and norms, and boasting of one's own achievements, inevitably leads to personal blame; thus, it is the second error.) Failing to adapt to the living conditions of patients based on their poverty, humility, wealth, or nobility; their clothing thickness; their body constitution regarding cold and heat; failing to consider dietary appropriateness; failing to distinguish between courage and timidity; and lacking the ability to use analogical reasoning (Bi Lei), which only leads to self-confusion rather than clarity, constitutes the third error in treatment. (Those of low status often labor, while those of high status enjoy leisure; leisure makes one less susceptible to pathogenic factors, while labor makes one more vulnerable. Regarding labor, the rich experience half the burden of the noble; regarding pathogens, the poor bear half the burden of the base. Generally, this holds true, though hereditary noble families may differ. Courageous individuals are hard to confuse, while timid individuals are easily injured; this difference lies in the strength of their Shen Qi. Understanding the implications of poverty and wealth clarifies the issues of clothing thickness, bodily temperature, and dietary suitability. Without analogical reasoning, medical practice will surely be erroneous, merely confusing one's mind, making profound understanding impossible; thus, it is the third error.) Failing to inquire about the onset of the disease, including emotional distress (You Huan), dietary irregularities, excessive lifestyle habits, or potential poisoning, and without addressing these beforehand, suddenly grasping the Cun Kou (Radial Pulse) to diagnose, one cannot accurately identify the disease. Making arbitrary diagnoses and being trapped by superficiality constitutes the fourth error in treatment.... (Distress refers to fear and anxiety; hardship refers to adversity. Dietary irregularity refers to overeating. Excessive lifestyle refers to depletion. 'Or injured by toxins' means the condition should not be rigidly treated solely based on Zang-Fu mutual overcoming methods. Note: Ignoring the causes of disease and merely palpating the Cun Kou pulse, while nominally diagnosing, actually fails to recognize the disease name. Such instances of the Four Errors are common.) Therefore, treatment that does not follow rational principles abandons medical arts to the marketplace; reckless treatment occasionally yields recovery, leading to foolish self-satisfaction. (Note: Unlearned and unskilled, merely peddling in the market; if one happens to succeed once, they boast arrogantly, continuing this way for life, accumulating countless faults.) Alas! The Way is profound and obscure; who truly knows it? (...Note: The Supreme Way is high and mysterious; the ignorance of the world is truly lamentable.)